Healthcare Provider Details

I. General information

NPI: 1578887485
Provider Name (Legal Business Name): LESLIE DRAPER OD PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/22/2010
Last Update Date: 07/18/2025
Certification Date: 07/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

915 MIDDLE RIVER DR STE 420
FORT LAUDERDALE FL
33304-3561
US

IV. Provider business mailing address

915 MIDDLE RIVER DR STE 420
FORT LAUDERDALE FL
33304-3561
US

V. Phone/Fax

Practice location:
  • Phone: 954-372-6822
  • Fax: 954-372-6838
Mailing address:
  • Phone: 954-372-6822
  • Fax: 954-372-6838

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code152W00000X
TaxonomyOptometrist
License Number
License Number State

VIII. Authorized Official

Name: DR. LESLIE DRAPER
Title or Position: OPTOMETRIC PHYSICIAN/OWNER
Credential: O.D.
Phone: 423-468-3305